By Karin Massie [@kmspice] (Senior Physiotherapist in Critical Care and AHP Practice Education Lead for NHS Grampian)
In December 2016 I began my QI journey. I began NHS Grampians local AHP Leadership and QI course led by Jenny Ingram , supported by Anne McKenzie and Rosie Cooper Also supported in my team by Stephen Friar who along with Faye Morren have been instrumental in moving things forward in our ICU.
So they say being part of QI is a simple way to enjoy your job more, I was dubious to begin with. How can a piece of work that will have to be done on top of my daily clinical and practice education role and all they contain be something other than stressful and exhausting? So the past 7 months have had some of that for sure but what there has definitely been, is team work, integration, conversations, expanding knowledge base, meeting people I would never had the opportunity to meet before, helping start a QI epidemic in our team, supporting others to address things they would like to see improve, increased knowledge of IT, discovery of the power of social media particularly Twitter and ultimately, the most important thing of all actually being able to have our team think about and adopt methods which can only but benefit patients and their long-term outcomes.
My change idea was to increase the level of mobility within our ICU for patients. Have the whole team “Thinking Mobility”, provide staff with tools to give them the confidence to address mobility even if Physiotherapy wasn’t available. It’s widely known that early progressive mobilisation reduced ventilator days, reduces long-term functional issues, reduces delirium and gives a sense of well-being. So what did we do?
We followed the QI methodology and tested, changed, tested, changed and implemented a tool to assess patients readiness to mobilise and what the options might be at those levels.
We got 100% compliance with the tool, increased our daily mobilisation of patients who were eligible from 50% to 80%, changed paperwork to keep us thinking mobility, informed our relatives and carers using info graphics, we advertised progress for staff, designed a logo, started a Twitter feed @AberdeenICUQI, started 2 weekly QI meetings and started educating our staff. So we are now stretching our aim to 100% of patients who are eligible to be mobilised daily.
I mean why not, who wants to be in the 20% that aren’t mobilised?
So it sounds a lot when you write it all down, and it was but so worth it. The best bit is our QI meeting started with 3 people and at last count we were over 20 with 5 QI projects underway compared to the zero at the beginning of the year. All projects aimed at improving patient care or staff experience. We have over 120 world-wide Twitter followers who share our work on a regular basis and this week NHS Grampian thought our ICU work should be seen by a representative from Scottish Government who was visiting.
Thinking about QI and Leadership training? Just do it. You won’t regret it. I certainly don’t. Want to know more about what we have done? Get in touch firstname.lastname@example.org @kmspice